Drug Use During Pregnancy and Lactation

Larimore, Walter L.; Petrie, Kent

doi:10.1016/s0095-4543(05)70147-0

Cited by 18 publications

(6 citation statements)

References 17 publications

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“…[58] In the vast majority of cases, the use of antibiotics is essential and can prevent patients from experiencing important morbidity and/or mortality. [1,13,59,[61][62][63] Although antibiotics are one of the most common medications prescribed to lactating women, compliance with the prescribed regimen appears to be very low [14] because of misguided concerns regarding antibiotic transfer into breast milk. Antibiotics are prescribed to postpartum women for a variety of reasons, including but not limited to: perioperative prophylaxis in Cesarean sections, premature rupture of membranes, endometritis, obstetric complications, perineal tear, urinary tract infections, sexually transmitted diseases, vaginitis, mastitis, giardiasis and respiratory tract infections.…”

Section: Antibioticsmentioning

confidence: 99%

“…[58,64,65] In postpartum women, penicillins and cefalosporins are frequently used for the treatment of mastitis [61,[66][67][68] or infections of the genital and/or urinary tracts. [58,64,65] In postpartum women, penicillins and cefalosporins are frequently used for the treatment of mastitis [61,[66][67][68] or infections of the genital and/or urinary tracts.…”

Section: β-Lactam Antibioticsmentioning

confidence: 99%

“…[61] The aminoglycosides are large (molecular weight 400-800 daltons), polar molecules with minimal protein binding and tissue/ body fluid distribution. These drugs are commonly used, in conjunction with a penicillin or clindamycin, for the treatment of postpartum women with post-Caesarean section endometritis, intra-amniotic infections, sepsis or pyelonephritis.…”

Section: Aminoglycosidesmentioning

confidence: 99%

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Antibiotics and Breast-Feeding

2002

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Continuous breast-feeding, an integral component of the postpartum period, is often threatened upon maternal initiation of antibiotics. The real risk of antibiotic use while breast-feeding must be carefully analysed with regard to all the variables that influence the extent of antibiotic distribution into breast milk, including breast milk composition, physicochemical properties of the antibiotic (molecular weight, lipid solubility, pH, protein binding), length of feeding, and maternal disposition. In addition, infant disposition, including ability to absorb, metabolize, eliminate, and tolerate any amounts of antibiotic, must also be considered prior to maternal administration of antibiotic. The milk to plasma (M/P) ratio is a frequently quoted parameter used to predict drug distribution into breast milk. However, its utility is questionable and often fraught with misinterpretation. An alternative approach when the amount of antibiotic concentration in breast milk is known (through clinical trials) is to calculate an estimated or expected infant drug exposure factoring in known/expected milk consumption, drug concentration and bioavailability. In this review, the following antibiotic classes and current literature regarding their distribution into breast milk are critically reviewed: beta-lactam antibiotics, fluoroquinolones, sulfonamides, macrolides, aminoglycosides, tetracyclines, nitrofurantoin, metronidazole, vancomycin, clindamycin and chloramphenicol. In the majority of instances, these antibiotics do not distribute into breast milk in sufficient concentrations to be of any clinical consequence in the breast-feeding infant.

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Section: Antibioticsmentioning

confidence: 99%

Section: β-Lactam Antibioticsmentioning

confidence: 99%

Section: Aminoglycosidesmentioning

confidence: 99%

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Antibiotics and Breast-Feeding

2002

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“…Sua ação anti-hiperglicemiante se deve a aumento da liberação da insulina pelo pâncreas, porém efeitos extrapancreáticos devem estar envolvidos 13 . A glibenclamida não cruza a barreira placentária, não altera os níveis de insulina fetal, não está associada ao aumento da mortalidade perinatal e apresenta resultados perinatais iguais aos obtidos com insulina.…”

Section: Introductionunclassified

“…A glibenclamida, a acarbose e a insulina são classificadas como classe B para uso durante a gestação, isto é, sem efeitos deletérios para o feto. Isto foi demonstrado em pesquisas animais, não havendo estudos controlados que mostrem algum efeito nocivo em humanos, sem evidências de risco após o primeiro trimestre 13 . Além do custo elevado da insulinoterapia, temos a alta complexidade em relação ao seu uso e a rejeição das pacientes ao tratamento.…”

Section: Introductionunclassified

Resultados preliminares do uso de anti-hiperglicemiantes orais no diabete melito gestacional

Silva¹,

Taborda²,

Becker³

et al. 2005

Rev. Bras. Ginecol. Obstet.

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Objetivo: comparar a eficácia da glibenclamida e da acarbose com insulina no tratamento do diabete melito gestacional (DMG) em relação ao controle glicêmico materno, peso do recém-nascido (RN) e hipoglicemia neonatal. Métodos: trata-se de ensaio clínico randomizado, prospectivo e aberto. Foram incluídas 57 pacientes com diagnóstico de DMG, que necessitaram de terapêutica complementar à dietoterapia e à atividade física. As gestantes foram aleatoriamente alocadas em um de três grupos com terapêuticas diferentes: um grupo controle conduzido com insulinoterapia, outro com glibenclamida e outro com acarbose. O período do estudo foi de sete meses (1 o de outubro de 2003 a 1 o de maio de 2004). Os desfechos primários avaliados foram o nível glicêmico materno após o inicio do tratamento, a necessidade de troca de terapêutica para controle glicêmico, peso do RN e presença de hipoglicemia neonatal. A análise estatística foi realizada pelo teste estatístico ANOVA, com nível de significância de 5%. Resultados: as características maternas foram semelhantes nos três grupos estudados. O controle glicêmico não foi obtido em três pacientes que utilizaram glibenclamida (15%) e em sete das usuárias de acarbose (38,8%). Não houve diferença quanto à glicemia em jejum e pós-prandial e no peso médio do RN entre os três grupos. A incidência de fetos grandes para a idade gestacional foi de 5,2, 31,5 e 11,1% nos grupos tratados com insulina, glibenclamida e acarbose, respectivamente. A hipoglicemia neonatal ocorreu em seis RN, sendo quatro deles do grupo glibenclamida (21,0%). Conclusões: a glibenclamida foi mais eficiente para o controle glicêmico que a acarbose, mas ambos foram menos eficientes que a insulina. Os RN de pacientes alocadas no grupo glibenclamida apresentaram maior incidência de macrossomia e de hipoglicemia neonatal quando comparados com os RN cujas mães receberam outros tratamentos. PALAVRAS-CHAVE:Diabetes gestacional/quimioterapia; Glicemia/efeito de drogas; Macrossomia fetal ABSTRACT Purpose: to compare the effectiveness of glibenclamide and acarbose with that of insulin for the treatment of gestational diabetes mellitus (GDM), in regard to maternal glucose levels, newborn (NB) weight and neonatal hypoglycemia. Methods: an open, randomized prospective study was carried out. Fifty-seven patients diagnosed with GDM were included. These patients required dietary control and additional therapy. Pregnant women were randomly alloted to one of three groups with different therapies: a control group making use of insulin therapy, a study group making use of glibenclamide and a study group making use of acarbose. The study took seven months (from October 1st 2003 to May 1st 2004). Assessed outcomes were maternal glucose levels in the prenatal period, the need for replacing therapy to achieve glucose level control, NB weight and neonatal hypoglycemia. Statistical analysis was determined by ANOVA with the level of significance set at 5%. Results: maternal characteristics were similar in all the three groups. Glucose level contro...

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Current Awareness

2000

Pharmacoepidem. Drug Safe.

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of pharmacoepidemiology and drug safety. Each bibliography is divided into 19 sections: 1 Books, Reviews & Symposia; 2 General; 3 Anti‐infective Agents; 4 Cardiovascular System Agents; 5 CNS Depressive Agents; 6 Non‐steroidal Anti‐inflammatory Agents; 7 CNS Agents; 8 Anti‐neoplastic Agents; 9 Haematological Agents; 10 Neuroregulator‐Blocking Agents; 11 Dermatological Agents; 12 Immunosuppressive Agents; 13 Autonomic Agents; 14 Respiratory System Agents; 15 Neuromuscular Agents; 16 Reproductive System Agents; 17 Gastrointestinal System Agents; 18 Anti‐inflammatory Agents ‐ Steroidal; 19 Others. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted.

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Drug Use During Pregnancy and Lactation

Cited by 18 publications

References 17 publications

Antibiotics and Breast-Feeding

Antibiotics and Breast-Feeding

Resultados preliminares do uso de anti-hiperglicemiantes orais no diabete melito gestacional

Current Awareness

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